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| Trade/other name(s) Indocin, Indocin SR, Indotech |
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| Pronunciation: in-doh-meth-uh-sin | ||||
| Why would this drug be used? Indomethacin is a non-opioid pain medicine (analgesic) that belongs to the general class of drugs called non-steroidal anti-inflammatory drugs (NSAIDs). It may be used to treat mild to moderate pain from cancer, surgery, or other causes. For severe pain, it is more helpful when used along with other pain-relieving drugs. It is also used to reduce fever and inflammation, as well as for other purposes. |
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| How does this drug work? Indomethacin's action is not fully understood, but it helps block the body from making prostaglandins. This prevents pain receptors from passing the pain message to the brain so that pain perception is decreased. This drug reduces inflammation. It also reduces fever by helping enlarge blood vessels near the skin so that heat is lost from the body. Because the drug has serious side effects it is not commonly used for this purpose. |
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| Before taking this medicine Tell your doctor: |
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| Interactions with other drugs If you take indomethacin while you are taking lithium, your lithium level may go up. This can increase your risk of toxic effects from lithium. You may need more frequent monitoring of lithium levels while on indomethacin. Taking indomethacin while using "blood thinners" (such as warfarin and heparin) can increase your risk of serious bleeding. Aspirin and other non-steroidal anti-inflammatory medicines should not be used with indomethacin. Diflunisal especially has been reported to cause kidney failure and severe bleeding when taken with indomethacin. Alcohol may increase your risk of stomach irritation or bleeding, as may aspirin. Corticosteroids that are taken by mouth, such as prednisone, prednisolone, hydrocortisone, betamethasone, budesonide, triamcinolone, can also increase this risk. Many of the medicines used for high blood pressure, such as diuretics ("water pills"), angiotensin antagonists (such as candesartan, losartan, valsartan, and others), beta blockers (such as atenolol, timolol, metoprolol, propranolol, and others) and ACE inhibitors (such as captopril, lisinopril, enalapril, benazepril, and others) may not work as well if taken during treatment with indomethacin. You will need more frequent blood pressure checks and possibly a change of medicines. Methotrexate may have more toxic effects if indomethacin is taken during the same time. Your blood level of digoxin (for the heart) may go up while taking indomethacin. Be sure your doctor knows that you are on digoxin so that your blood levels can be watched more closely. Probenecid may increase the blood level of indomethacin and raise the risk of toxic effects. Your doctor may lower your indomethacin dose if you are on both drugs. Check with your doctor, nurse, or pharmacist about whether other medicines, vitamins, herbs, and supplements can cause problems with this medicine. |
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| Interactions with foods No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem. |
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Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug. |
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| How is this drug taken or given? Indomethacin can be taken by mouth or as a rectal suppository. Indomethacin comes as a capsule, extended-release capsule, or liquid. Do not open or crush the extended release capsule. Shake the liquid before pouring the dose. Take the medicine 3 to 4 times a day as directed with food, milk, or antacid to reduce the risk of upset stomach. To take the rectal suppository, open the package and dip the tip in water. If you are right-handed, lie down on your left side, bring your knees up near your chest, and insert the suppository in your rectum about an inch. Stay in this position for about 15 minutes, then get up and wash your hands well. Take this drug exactly as directed by your doctor. If you do not understand the instructions, ask your doctor or nurse to explain them to you. Keep the medicine in a tightly closed container away from heat and moisture and out of the reach of children and pets. |
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| Precautions Avoid aspirin or other non-steroidal anti-inflammatory drugs with indomethacin. They may increase the risk of stomach irritation and the occurrence of aplastic anemia (damage to the bone marrow which results in very low blood counts.) Aspirin is often added to other medicines. Read the ingredient list on any remedies for headache, sinus, cold or flu before taking them, or check with your pharmacist. Avoid indomethacin if you have a stomach or duodenal ulcer. Indomethacin can cause severe bleeding or holes in the intestine. If you have ever had trouble breathing, rash, itching, or swelling in the mouth, face, or throat after taking aspirin or other anti-inflammatory drugs, do not take indomethacin. If your blood counts are low due to chemotherapy or radiation, check with your doctor or nurse before taking indomethacin. It may increase your chance of bleeding. Call your doctor or nurse right away if you have bleeding from the stomach such as vomiting blood or a coffee-ground material, blood in your stool, or black, tarry stools. Stop taking indomethacin until after you talk with your doctor or nurse. Call your doctor or nurse right away if you have changes in vision or neurologic side effects occur (numbness and tingling, confusion, nightmares, or depression). Stop taking indomethacin until you talk to your doctor or nurse. If you notice any type of rash, especially if you also have a fever, stop the indomethacin and call your doctor right away. Indomethacin can cause fluid retention and worsen heart failure. If you have unexplained weight gain or swelling, stop the indomethacin and call your doctor. Indomethacin must be stopped a few days before any type of surgery. Make sure you tell your doctor or dentist at least a week before surgery if you are taking indomethacin to be sure of your instructions. Rarely, indomethacin can cause damage to the liver. If you notice nausea, tiredness, itching, tenderness below the right side of your rib cage, flu-like symptoms, or yellowing of the skin or eyes, stop the medicine and call your doctor or nurse right away. Indomethacin can increase your risk of heart attack and stroke. If you develop shortness of breath, chest pain, weakness, slurred speech, get help right away. If you have trouble breathing, itchy welts on the skin, or swelling of your mouth, face, or throat, get emergency help. Smoking or drinking alcohol increases your risk of bleeding from the stomach or intestine while taking this drug. Most cancer pain can be controlled. Keep your doctor or nurse informed about how well your pain medicines are working and any side effects you are having. Your cancer team may need to adjust your medicines several times before they find the medicines that work best for you. If your doctor prescribes another medicine for pain, ask your doctor or nurse whether you should continue taking indomethacin along with the new medicine. Severe pain usually requires more than one type of medicine to control it. If you have chronic cancer pain, take your pain medicines on a regular schedule to keep it from worsening. If you wait until the pain is bad, it takes more medicine to get it under control. If pain gets bad between doses, talk to your cancer team about changing your medicine or adding an extra one for "breakthrough" pain. |
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Possible side effects |
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Common
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Less common
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Rare
*See "Precautions" section for more detailed information. |
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There are other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems. |
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| FDA approval Yes - first approved before 1984 (FDA cannot verify dates of drugs approved before 1984). |
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| Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs. | ||||
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